Korean J Obstet Gynecol.  2011 Jun;54(6):317-321. 10.5468/KJOG.2011.54.6.317.

Concurrent chemoradiation-related superior mesenteric artery occlusion in the patient with advanced endometrioid endometrial cancer after surgery

• Kim K
• Kim JY
• Hong KC
• Kim H
• Han J
• Song E

• KMID: 2274042
• DOI: http://doi.org/10.5468/KJOG.2011.54.6.317

Abstract

The incidence of endometrial cancer (EC) has increased and it has approximately 16% of gynecologic cancers in Korea. For loco-regional or distant recurrence, adjuvant treatment after surgery is very important in patients with intermediate- or high-risk EC (IHR-EC). Recently clinical trials for treating patients with IHR-EC are focused on the efficacy of concurrent chemoradiation (CCR). However, increase in intestinal complications in the group of radiotherapy combined with chemotherapy was reported. In case of chemoradiation-related superior mesenteric artery (SMA) occlusion, it could be fatal nevertheless with intensive care. We present a case report of radiation-related arteritis leading to stenosis in SMA, which led the patient with EC to death in a year after CCR.

Keyword

Endometrial neoplasms; Radiotherapy, adjuvant; Chemotherapy, adjuvant; Mesenteric vascular occlusion

MeSH Terms

Arteritis
Chemotherapy, Adjuvant
Constriction, Pathologic
Endometrial Neoplasms
Female
Humans
Incidence
Critical Care
Korea
Mesenteric Artery, Superior
Mesenteric Vascular Occlusion
Radiotherapy, Adjuvant
Recurrence

Figure

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  Fig. 1 This slide shows (A) endometrial cancer grade 1 (H&E, ×100), and (B) positive lymph node metastases (H&E, ×20).

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  Fig. 2 Simple X-ray films before operation. (A, B) Simple abdomen erect and supine showed normal finding but multiple surgical clips in mid abdomen. (C, D) Just before operation, simple X-ray hinted at ileus with diffuse edematous bowel wall thickening.

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  Fig. 3 CT showed small bowel ischemia with superior mesenteric artery thrombosis.

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  Fig. 4 (A) The nearly totally resected intestine at emergency operation. There were foul odor and the intestine had shown ischemic and necrotic appearance. (B) This slide shows thrombus with intimal fibrinous necrosis and fibrosis (H&E, ×100).

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